Fecal incontinence - Challenges and solutions

Ruiz, Nallely Saldana; Kaiser, Andreas M.

doi:10.3748/wjg.v23.i1.11

Cited by 114 publications

(95 citation statements)

References 95 publications

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“…As treatment options are limited and are associated with side-effects, faecal incontinence is a devastating outcome. 42,43 Dyspareunia occurred more frequently after SSHP. There is a wide variation in LSH techniques on several key points, such as level of dissection, mesh type and tension of the mesh.…”

Section: Discussionmentioning

confidence: 99%

Hysteropexy in the treatment of uterine prolapse stage 2 or higher: laparoscopic sacrohysteropexy versus sacrospinous hysteropexy—a multicentre randomised controlled trial (LAVA trial)

IJsselmuiden

Oudheusden

Veen

et al. 2020

BJOG

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Objective To investigate whether laparoscopic sacrohysteropexy (LSH) is non‐inferior to vaginal sacrospinous hysteropexy (SSHP) in the surgical treatment of uterine prolapse. Design Multicentre randomised controlled, non‐blinded non‐inferiority trial. Setting Five non‐university teaching hospitals in the Netherlands, one university hospital in Belgium. Population 126 women with uterine prolapse stage 2 or higher undergoing surgery without previous pelvic floor surgery. Methods Randomisation in a 1:1 ratio to LSH or SSHP, stratified per centre and severity of the uterine prolapse. The predefined inferiority margin was an increase in surgical failure rate of 10%. Main outcome measures Primary outcome was surgical failure, defined as recurrence of uterine prolapse (POP‐Q ≥ 2) with bothersome bulging/protrusion symptoms and/or repeat surgery or pessary at 12 months postoperatively. Secondary outcomes were anatomical recurrence (any compartment), functional outcome and quality of life. Results Laparoscopic sacrohysteropexy was non‐inferior for surgical failure (n = 1, 1.6%) compared with SSHP (n = 2, 3.3%, difference −1.7%, 95% CI: −7.1 to 3.7) 12 months postoperatively. Overall, anatomical recurrences and quality of life did not differ. More bothersome symptoms of overactive bladder (OAB) and faecal incontinence were reported after LSH. Dyspareunia was more frequently reported after SSHP. Conclusion Laparoscopic sacrohysteropexy was non‐inferior to SSHP for surgical failure of the apical compartment at 12 months’ follow up. Following LSH, bothersome OAB and faecal incontinence were more frequent, but dyspareunia was less frequent. Tweetable abstract Laparoscopic sacrohysteropexy and vaginal sacrospinous hysteropexy have equally good short‐term outcomes.

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Section: Discussionmentioning

confidence: 99%

Hysteropexy in the treatment of uterine prolapse stage 2 or higher: laparoscopic sacrohysteropexy versus sacrospinous hysteropexy—a multicentre randomised controlled trial (LAVA trial)

IJsselmuiden

Oudheusden

Veen

et al. 2020

BJOG

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“…However, the number of instruments for its evaluation is limited. [10][11][12] The first specific instrument for the assessment of AI was the FIQL in its original version, which was prepared in 2000 and was proposed by Rockwood et al, 13 Other instruments in the literature are: the Wexner scale (WS), the Manchester Health Questionnaire (MHQ), the Modified Manchester Health Questionnaire (MMHQ), and the Rapid Assessment Faecal Incontinence Score (RAFIS). 8,[14][15][16] Even fewer QoL instruments related to AI have been validated for Brazilian Portuguese.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life in Women with Defecatory Dysfunctions: Systematic Review of Questionnaires Validated in the Portuguese Language

Neto

Vasconcelos

Karbage³

et al. 2019

Rev Bras Ginecol Obstet

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Objective To identify the quality of life (QoL) assessment instruments related to the health of women with fecal incontinence (FI) or anal incontinence (AI). Data Sources Systematic review conducted in the Virtual Health Library (VHL), PubMed and Cochrane Library databases. The descriptors used were: Questionnaire, Questionnaires, Quality of life, validation, validation Studies, anal incontinence, fecal incontinence and constipation. The search was performed between December 26, 2017 and the beginning of January 2018. The limits used were female gender. Selection of Studies Initially, 5,143 articles were obtained in the search. The articles of validation for Portuguese of questionnaires for the evaluation of the impact of FI/AI on the QoL of women were considered eligible. Data Collection The article search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Data Synthesis Of the 5,143 articles, only 2 fulfilled the inclusion and exclusion criteria: Fecal Incontinence Quality of Life (FIQL) and the Wexner scale (WS). The FIQL evaluates the QoL related to FI, not covering flatus incontinence. The WS assesses flatus incontinence and the severity of the AI. The WS obtained an interclass correlation coefficient (ICC) of 0.932 and a Cronbach α coefficient > 0.90. The FIQL obtained intraexaminer and interexaminer reproducibility ranging from 0.929 to 0.957 and from 0.944 to 0.969, respectively. Conclusions The WS and the FIQL have satisfactory reliability and validity for use during gynecological consultations.

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“…Sphincter tears can be underdiagnosed at the time of delivery and can lead to severe complications and sequelae, including FI even 20 or 30 years after. EAUS diagnosis of anal sphincter tears after childbirth and before reconstruction of OASIS is superior to clinical evaluation and reduces the possibility of FI [13][14][15] . In men, the main cause of FI is anorectal surgery 16 .…”

Section: Causes Of Fimentioning

confidence: 99%